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The folks behind the Mediterranean Diet Pyramid just revised the popular, science-based eating plan to recommend more fish, herbs, and spices.

The changes reflect recent research that’s helped explain exactly why the sunny coastal region’s healthiest diets reduce rates of disease and lengthen life spans (To compare the old and new pyramids, see “Fish, herbs, and spices...”, below).

In truth, what we now call the “Mediterranean” diet actually describes an idealized version of the diet enjoyed by Aegean islanders until American-style foods started to invade their shores in the 1970s.

This proven-healthful version of the Mediterranean diet is rich in green vegetables, fruits, nuts, beans, fish, and olive oil, and has been linked to longer life, less heart disease, and protection against some cancers.

The authors of a recent, exhaustive, evidence review conclude that of all the various diets associated with better heart health, only the Mediterranean diet has been clinically proven to reduce risk of coronary heart disease (Mente A et al. 2009).

The benefits of the idealized, Aegean-style Mediterranean diet are believed to flow from its abundance of fiber, antioxidant polyphenol compounds, vitamins, minerals, and omega-3 fats (from fish, grass-fed poultry, and green plants).

The original Mediterranean diet pyramid was developed in 1993 by Oldways, a non-profit organization that promotes eating patterns proven healthful in scientific studies.

Fish, herbs, and spices receive new emphasisOver the last several years, reams of new research have bolstered claims made for the health benefits of the Mediterranean diet, and the insights provided by these studies prompted Oldways to revise their pyramid.

The re-design of the pyramid draws on the conclusions of leading nutrition and health experts who convened for a three-day conference in November of 2008, sponsored by Oldways.

As a result of the conference consensus, Oldways made two major changes to its Mediterranean diet pyramid:

More frequent enjoyment of fish. Instead of just once a week, the pyramid now recommends consuming fish and shellfish at least two times a week, thanks to mounting scientific evidence for the importance of omega-3 fish fats to brain, heart, and developmental health.

The addition of herbs and spices. Oldways added herbs and spices to the pyramid to reflect increased evidence of their health-promoting characteristics—which flow largely from their unequalled antioxidant content—and the role they play in increasing the palatability of foods.

In addition, Oldways’ Mediterranean diet now groups all recommended plant foods—fruits, vegetables, grains, nuts, legumes, seeds, olives and olive oil—at the base of the pyramid, to indicate that they should be the basis of most meals.

The new Mediterranean Diet Pyramid, describedThe parts of the Mediterranean region that enjoy the lowest recorded rates of chronic diseases and the highest adult life expectancy—largely, the Aegean islands—show a pattern like the one described in the Oldways list below.

Moderate consumption of wine, normally with meals; about one to two glasses per day for men and one glass per day for women (wine should be considered optional and avoided when consumption would put the individual or others at risk).

Notes from the 2008 Oldways conference one new Mediterranean diet research offers these additional points on the role of fish in the Mediterranean diet:

“Tuna, herring, sardines, salmon and bream are rich in essential heart-healthy omega-3 fatty acids... fish and shellfish are not typically battered and fried in Mediterranean countries, as they are in many other countries, including the U.S.”

We would add that several studies show that battered fish do not reduce stroke risk like non-fried fish do.

This is probably because deep-frying fat is very high in omega-6 fats, which can be pro-inflammatory and compete with the anti-inflammatory, stroke-fighting omega-3 fats in fish.

And a 2006 clinical study found that eating a Mediterranean diet resulted in a better balance between blood levels of omega-3 fats and the omega-6 fats, and improved several risk factors for cardiovascular disease. (Ambring A et al. 2006)

Being unable to resist a cheap crack, we've said it before and probably will again: “Eat like a Cretan.”